ES2907256T3 - Surgical staple applier - Google Patents

Abstract

Universal handle of a surgical staple applier (1) on which an individual staple magazine (4) that can be selected from a number of different staple magazines and featuring a crimping head/crimping tool ( 20, 22) so that the universal handle (2) and individual staple magazine (4) attached to it for crimping individual staples (46) into the crimping head/crimping tool (20, 22) and for carrying staples from a staple receiving section (48) interact mechanically via a single input path to the crimping head/crimping tool (20, 22), for which the universal handle (2) has a transmission gear of integrated power (54) with at least one handle (6, 8) that can be held manually as a drive input part and with a coupling as a drive output part to the individual staple magazine (4), characterized by a device d e adaptation (50, 52) with overload protection (50) which is arranged between the drive input part and the drive output part to interrupt the force transmission in the force transmission gear (54) when the transport of individual staples from the staple magazine (4) is limited by at least one stop (42, 44), for compensation/accommodation of staple-related differences between the individual input path of the individual staple magazine (4) currently connected and a maximum drive path from the drive input part on the universal handle (2).

Description

DESCRIPTION

Surgical staple applier

The disclosure relates to a surgical staple applier, a staple magazine for the staple applier, and a handle for releasably holding the staple magazine.

Background of the invention

Staple appliers are surgical instruments for placing (applying) tissue staples into a patient's tissue, for example, to close a suture or a vessel. This eliminates the need for time-consuming stitching, which is particularly advantageous for surgical sites that are difficult to access from the outside. State of the art

A generic staple applicator is known, for example, from DE 20 2011 000 755 U1. This type of staple applier can be used in open and endoscopic surgery to connect tissue structures of a patient to be operated on quickly and reliably by applying and then closing preferably U-shaped or V-shaped staples. In particular, an applicator Such staples can be used to quickly and safely clamp a patient's blood vessels. Various types of staples can be used here, which can differ, for example, in their shape, but also in their size and strength.

The staple applicator described in DE 20 2011 000 755 U1, the disclosure of which is also the subject of this application, has a handle part on which a staple magazine with an integrated staple magazine can be removably attached. The handle part is provided and configured accordingly so that it can be used multiple times as a reusable part (reusable part). Rather, the staple magazine is designed and configured in such a way that it can only be used as a discard part (disposable part) until the staples stored in the staple magazine of the staple magazine are exhausted.

Although this staple applier can be provided comparatively cheaply and also allows staples to be applied and closed comparatively safely, it would be desirable to improve the handling of the staple applier. This desire is due to the fact that the handle portion of this staple applicator is only intended to be combined with staple magazines of the same staple type/art and staple size. In other words, only one specific type of staple can be applied with a single piece of handle, despite the replacement of individual staple magazines. This means that in the OR, under certain circumstances, a large number of different handle parts and a large number of different staple magazines must be available, of which each combination of handle part and staple magazine can only be used for a single staple. However, this has a disadvantageous effect on the available space and clarity in the operating room.

Another state of the art is described in DE 4429084 C1. The staple applicator described therein also allows for a comparatively easy change of a staple magazine, which can be releasably inserted through a side opening into a tubular shaft of the staple applicator. The staple magazine is designed as a disposable part, while the handle part and the tubular shaft that can be attached to it are designed as reusable parts. This staple applicator also offers the possibility of joining different tubular shafts, which differ from each other, for example in terms of shaft length, to a single shaft part. Although this staple applicator allows for relatively flexible handling, it is still necessary to change both the tubular shaft and the staple magazine for the application of different types of staples. Therefore, it remains desirable to improve the handling of the staple applier of the type described above.

Also, from US 6599298 B1, a staple applicator is known having a handle portion and an attachable staple magazine, both of which are designed as disposable parts. The staple magazine is built into a staple applicator stem, with different stem lengths that can hold or store a different number of staples and apply them if needed. However, this staple applicator also does not offer the possibility of applying different types of staples with the same staple applicator, so it is still desired to improve the handling of the staple applicator of the type described at the outset.

WO 00/42922 A1 discloses a staple applier for placing and attaching surgical staples. The staple applicator has a handle (pair of handles) with staples in an interchangeable magazine.

US 2011/024145 A1 discloses a surgical device (handle with drive elements) for minimally invasive interventions and a force limiting coupling. A coupling prevents excessive forces from acting on the distal end of the surgical device, which could cause harm to the patient.

US 2008/083813 A1 discloses a handle for a surgical instrument with a mechanical overload limiter.

US 4611 595 A discloses a surgical staple applier having a handle to which a surgical staple magazine can be attached. The staple magazine is interchangeable.

Brief description of the invention

Starting from DE 20 2011 000 755 U1, the invention has the object of creating a surgical clip applier which can be provided comparatively cheaply and in which handling is improved by using means that are as simple as possible in terms of design. . An objective here is to improve the flexibility of the staple applier with respect to the possible use of different types of staples. Another objective or an additional objective is to be able to provide staple applier components designed as disposable parts in the most economical way possible.

This problem is solved by a universal handle with the features of claim 1 and by a staple applicator with universal handle and individual staple magazine with the features of claim 5. Advantageous developments of the invention are specified in the dependent claims. According to a first aspect of the present disclosure, there is therefore proposed a universal handle of a surgical staple applicator, on which a magazine for individual staples can be mounted, having a crimping head and can be selected from several different staple magazines such that the universal handle and the individual staple magazine for crimping individual staples in the crimping head as well as for conveying individual staples from a staple receiving section of the individual staple magazine through a Individual feed path to the crimp head interact mechanically. To do this, the universal handle has an integrated power transmission mechanism or a joint with at least one hand grip handle (handle, scissor handles, etc.) as a drive input part and with a coupling as a power output part. drive to the individual staple magazine. An adaptation device is provided between the drive input part and the drive output part, which is adapted to compensate or adapt the staple-related differences between the individual input path of the currently connected individual staple magazine and the path maximum drive force of the drive input portion on the universal handle.

As a result, the universal handle can be equipped with a drive mechanism that is provided with a specific maximum drive stroke/amount, which is intended for the application of the appropriate staples for this maximum drive stroke/amount. If now also staples requiring a smaller drive amount/travel are to be applied, the adaptation device compensates or adjusts the maximum drive amount/travel with reference to the drive amount/travel defined by the individual staple magazine. This means that the universal handle can also be used for different staples.

It is advantageous if the adaptive device is an overload protection for interrupting the transmission of power in the drive, preferably in the form of a sliding coupling or release mechanism. In particular, the slip coupling can then be set to a slip value above the force required to transport individual staples from the staple magazine through the individual feed path to the crimp head and below a predetermined actuation force. overloading the power transmission mechanism. Therefore, there is no need to make any changes (translation changes, etc.) to the power transmission mechanism or the linkage, thus the operation of the universal handle is simplified in general.

In accordance with another aspect of the present disclosure, there is proposed a surgical staple applier with a universal handle as described above and a mountable individual staple magazine having a crimping head, a staple receiving and a staple feeding device for transporting the individual staples from the staple receiving section have an individual delivery path to the crimping head depending on the manual actuation of the universal handle. The single staple magazine, which can be selected from a large number of staple magazines for different types of staples as required, is intended to have an integrated coding mechanism designed according to the type of staple to be applied, with the that at least the feed path is adapted to the respective staple type is or is defined. The coding mechanism has two stops to limit the movement of the staple feed device in both longitudinal directions. The staple feed device is adapted to cooperate with a latching/engaging portion at the distal end of a drive output/output member on a universal handle adapter.

In other words, a coding mechanism is firmly integrated into the different staple magazines, so that different staple magazines of different sizes/lengths and/or with different sizes can be used. types of staples with a universal handle. In this context, the delivery path is to be understood as the transport path for individual staples from a staple receiving/staple magazine section of the staple magazine to the crimping head.

By integrating the coding mechanism for defining the input path adapted to the respective staple type in the staple magazine, it is possible to attach (removably) a large number of different staple magazines to a single (universal) handle, interchange them if necessary and apply the stored staples. Essentially shaft-shaped staple magazines can have different shaft lengths. In addition, different types of staples can also be stored in the different staple magazines, which differ from each other, for example, in their shape and/or size and/or strength. This means that a single (universal) handle can be combined with a large number, eg two, three, four, five or more, of different staple magazines in order to apply different types of staples while maintaining the same handle.

The invention thus effectively improves the handling of the staple applicator and the space available in the operating room, since different types of staples or different staple applicator shaft lengths can be applied simply by changing the staple magazine with a single movement, simply by selecting and changing the staple loader accordingly the staple loader can be realized. Therefore, the invention also effectively reduces the number of different staple appliers that must be maintained or made available in the operating room. In this way, the invention contributes to improving clarity in the operating room.

Furthermore, the coding mechanism integrated in the respective staple magazine advantageously means that fewer reusable handles have to be sterilized after an operation.

The coding mechanism preferably has a staple feed device with at least one stop acting in the longitudinal direction of the staple feed device to at least partially define the feed path. In other words, the staple feed device is a first component of the coding mechanism, which ensures the feed path of individual staples. For example, the staple feed device can be embodied as a staple feed rod which is shaped or configured in such a way that with each manual actuation of the handle by the user and as a result of longitudinal movement caused thereby, only a single staple of a plurality of staple magazines stores staples and is transported to or within the application tool. In particular, the at least one limit stop on the staple feed device can limit a backward and/or forward movement of the staple feed device in the longitudinal direction of the axis of the handle, thus ensuring that a single staple is taken. of the staple magazine and its transport to the crimping head is ensured. In this case, the adaptation device on the side of the handle is activated when the stop is reached. This means that in the case of a slip coupling or a corresponding release mechanism, a further actuation of the gripping lever is allowed without this being transmitted to the individual staple magazine.

Another optionally independent or additional aspect of the disclosure foresees that the staple feeding device has two stops separated from each other in the longitudinal direction/advance direction, whose positions and/or distances are adjusted depending on the type of staple to be applied, such that, by moving the staple feed device backwards and/or forwards, exactly one individual staple can be taken from the staple magazine and transported exactly to the crimping head. The position of the stops depends in particular on the size of the staple and/or the thickness and/or the shape to be applied, and possibly the number of staples to be held in the staple magazine and/or the length of the shaft.

It has proven to be advantageous if the at least one stop is integrated into the staple feed device as a cutting and/or bending part, in order to thereby provide a staple magazine that can be provided comparatively inexpensively. For example, the feed device may be a type of staple feed rod which can be made economically from sheet metal or the like. The at least one stop can then be economically punched out of the sheet metal and, if necessary, can be bent open. As an alternative to this, it is also conceivable to design the staple feed device as a plastic part with an integrated stop.

Another possibly independent or additional aspect of the disclosure provides that the staple magazine coding mechanism also has a crimping head (jaw part) adapted to the type of staple to be applied. In other words, the crimping head, which is structurally matched to the respective staple type, may be a component of the staple magazine coding mechanism to ensure that the staples close properly when applied. This means that the coding mechanism can also have a crimping head adapted to the type of staple to be applied as an alternative to or in addition to the stop formed on the staple feed device. This makes it possible to reliably and safely apply and close staples of different sizes, strengths or shapes and/or shank lengths without adapting the handle part (universal). In this case, the mechanism inside the magazine for opening and closing the crimping head is also correspondingly adapted to be actuated using the handle. It is advantageous that the drive mechanism of the magazine's internal crimping head requires a stroke/amount of drive uniform for all the different magazines, so that its actuation by the attached universal handle does not require an adaptation device, as in the case of the individual feeding device.

In a particularly advantageous embodiment of the invention, the crimping head has a joint that controls closing and opening, whose position and/or geometric shape is adapted to the type of staple to be applied and/or to the length of the magazine shaft. of staples. For example, the connecting link can be positioned on the crimping head or geometrically shaped in such a way that the closing movement of the crimping head with a comparatively large clamp differs from the closing movement of the crimping head with a comparatively small clamp. . Then the drive mechanism of the crimping head in the magazine can be standardized.

It has been found to be advantageous if the staple magazine crimp head is adapted to contact the at least one limit stop of the staple feeder, thereby limiting backward and/or forward movement of the staple feeder. In other words, the staple loader crimping head and the staple loader staple feeding device can interact in such a way that only one staple is taken from the staple loader and conveyed to the application tool.

According to another possibly independent or additional aspect of the disclosure, the handle has the aforementioned overload protection that interacts with the staple magazine coding mechanism and that, when the handle is manually actuated, prevents damage to the handle and/or or the staple magazine attached to it due to excessive operating forces. This means that the flexible handling of the universally usable handle part is further enhanced by the fact that a (mechanical) overload protection is firmly integrated in the handle.

In a particularly cost effective embodiment of the disclosure, the handle can be designed as a reusable part. This means that the handle, which can be used universally with different staple magazines, can also be used in various operations after sterilization.

For hygiene reasons, each of the plurality of staple magazines can be designed as a disposable part.

According to another possibly independent or additional aspect of the disclosure, the handle and/or the staple magazine can have a color/symbol coding adapted to the type of staple to be applied to visualize the staple magazine that can be used with the handle. . For example, a staple magazine housing can be colored with a color associated with a specific staple type. For unambiguous assignment of the staple magazine to a handle that can be used with it, a corresponding assignable color code can be attached to the handle. This color coding of the two joinable parts of the staple applicator makes it possible to use the staple applicator in a particularly intuitive way.

In summary, the disclosure therefore provides for a surgical staple applier to be comprised of the handle and the staple loader. The staple loader is manufactured/provided as a separate component from the handle and can be removably attached/assembled as required, with the attached handle and staple loader interacting to form a single staple application tool and entry path defined for transporting individual staples from the staple magazine to the magazine crimp head. According to the disclosure, the staple magazine that can be selected according to the needs of a large number of different staple magazines for different types of staples has a built-in coding mechanism that is designed based on the type of staple to be loaded. apply and defining at least the feeding path adapted to the respective staple type.

The handle may have an integrated shaft into which the staple magazine can be at least partially inserted and possibly also stapled. A specific number of staples may be disposed or stored in each staple magazine of the plurality of staple magazines. The number of individual staples stored in the staple memory may be from five to forty staples, but preferably from 20 to 30 staples. The individual staple magazines of the large number of staple magazines differ from each other in that they can hold a different number of staples depending on their size (length). Other distinguishing features of individual staple magazines are the size/width, design (U-shaped or V-shaped), and strength or thickness of the individual staples stored in them, which can be accommodated in the magazine. respective staples. These different staples can be labeled, for example, "small", "medium", "medium-large" or "large" to differentiate between them. However, the staple magazines of the large number of staple magazines can also differ in the length of the shaft to be achieved or in the total length of the applicator, which can be, for example, 240 mm, 290 mm or 340 mm.

The universal handle can be configured, for example, to be combined with a staple magazine which stores 20 staples of the "small" size and when combined together, i.e. assembled, results in an applicator length of 240mm. However, the same handle can also be configured to be combined with a staple magazine that stores 20 "medium" size staples and when combined results in an applicator length of 240mm.

According to this combination scheme, at least and/or for example, the combinations of universal handles with respective staple magazines shown in the following table are conceivable to be assembled to form a staple applicator:

Description of the figures

The invention is explained in more detail below using a preferred embodiment with reference to the attached figures. In them:

Figure 1 shows a top perspective view of a staple applicator according to the invention, consisting of a handle or handle piece and a staple magazine that can be attached to it.

figure 2 shows a top perspective view of the staple applicator according to the invention of figure 1 in an assembled state, in which the staple magazine is removably attached to the handle part, figure 3 is a bottom view perspective view of a staple magazine, partially disassembled for illustrative purposes,

Figure 4 is a bottom perspective view of a portion of a staple magazine, partially disassembled for illustrative purposes, and

Figure 5 shows a perspective side view of a staple applicator according to the invention, consisting of a handle piece and a staple magazine attached thereto and partially disassembled for illustrative purposes. Identical or similar components are always provided with the same reference symbols.

Figure 1 shows a general perspective view of a Clip-Applicator set 1 according to the invention, consisting of a universal (reusable) handle 2 and a series of individual (single-use) selectable clip magazines individually, of which a single clip magazine 4 is shown here as an example. Such a clip applier 1 can be used, for example, in open and/or endoscopic surgery to connect tissue structures of a patient to one another quickly and reliably or to clamp a patient's blood vessels quickly and reliably.

The handle 2 according to the following detailed description and the essentially shaft-shaped staple magazine 4 according to the following detailed description are each generally configured so that the staple magazine 4 selected from the plurality of staple magazines is can be releasably attached to the handle 2, in order to form the staple applier 1 together in this way. For illustration purposes, the handle 2 and staple magazine 4 are shown here separately.

A specific number of staples are disposed or stored/stored in each staple magazine of the multiplicity of shaft-shaped staple magazines. Usually about five to forty staples, but preferably 20 to 30 staples, are arranged in a staple magazine. The individual staple magazines of the large number of staple magazines differ from each other in that they can accommodate a different number of staples due to their size or length. Other distinguishing features of individual staple magazines are the size/width, design (U-shaped or V-shaped), and the strength or thickness of the individual staples that can be accommodated in the respective staple magazine. However, the various staple magazines of the large number of staple magazines may also differ in their overall length, in particular their shaft length.

The need-based or need-based selection of a specific staple magazine 4 from the large number of staple magazines for attachment to the handle 2 can be based on, for example, which structure of tissue to be stapled in the specific case in hand, or, for example, also in the size of the structure to hold the blood vessels of the patient. In order to clearly indicate to the user which staple magazine 4 can/can be used with which handle 2, the handle 2 has at least two markings 5a and 5b on its upper side facing the user, which identify the handle 2 as a staple magazine. staples 4 identify shaped or shaped handle. In this exemplary embodiment, markings 5a, 5b are designed as colored circular markings that intuitively show the user which specific embodiment of the handle piece it is. In this embodiment, it is in the universal handle 2 to an initially mentioned "model 1 handle" for the staple sizes to be applied "small (English: small)" and/or "medium (English: medium)", which accordingly across the two color markings 5a, 5b, eg yellow for "small" and blue for "medium". Accordingly, a corresponding staple magazine casing 4, which is preferably made of plastic, is colored or color coded, namely yellow in this embodiment, to identify the type of staple stored in the staple magazine. 4 as "small".

handle construction

According to figures 1 and 5, the handle 2 has a central casing 2a to house a drive/articulation mechanism 54, in whose distal end section two side grip levers/scissor handles 6 and 8 as operating elements for the operation manual of the staple applier 1 by a user, for example an operator or surgeon, are hinged in such a way that the handle levers 6, 8 extend in a proximal direction on both sides of the central housing 2a. The gripping levers 6, 8 are structurally adapted/approximated at their free proximal ends to the anatomy of a user's gripping hand.

In addition, the handle 2 has at its distal end section (from the user's point of view) a stem 10 which is (materially) formed in one piece with the housing 2a or is attached to it and is U-shaped in section. transverse, in which an activation or crimp closure device 12 in the form of a longitudinally movable U-slide and a clamping part 14 in the form of a bolt fixed (welded) to the shaft 10 protruding perpendicularly from the bottom are integrated of the shaft of the U-shaped handle 10 in a central longitudinal portion.

The exact function of the locking device 12 and the holding part 14 is explained in detail below. In figure 1, however, it can be seen that the locking device 12, which is designed as a U-shaped slider, has a slot-shaped recess (opening) 15 in its longitudinal central section, through which the bolt 14 protrudes, allowing a relative movement of the locking device (U-shaped slider) 12 in front of the bolt 14 in the longitudinal direction of the axis of the handle 10.

Furthermore, the length and width of the shaft 10 of the handle 2 are designed in such a way that the essentially shaft-shaped staple magazine 4 can be inserted at least partially into the shaft 10 in such a way that the handle 2 and the staple magazine 4 selected to match in the assembled state results in an overall staple applicator length of 240mm to 340mm, in this embodiment 240mm.

According to FIGS. 1 and 5, in the housing 2a of the handle 2 a longitudinally movable bolt 18 that can be actuated from the outside is housed, which preferably forms a latching tongue or bar at its distal edge section. Bolt 18 is distally biased to a locked position by spring 54 not shown in detail in Figure 1 (but see Figure 5).

The casing 2a has, on its two sides facing the handle levers 6, 8, longitudinal grooves into which two connecting rods (tension/compression rods) 56, 58 are inserted, connecting the two handle levers 6, 8. with the drive mechanism 54 of the handle 2 or engage with the locking device 12. In the present case, the drive gear 54 consists of a preferably rod-shaped drive unit, which is disposed longitudinally displaceable with respect to the closure device 12, for a staple feed device, to be described below, of an inserted staple magazine 4.

This drive unit 54 preferably has an internally longitudinally movable input element, on which a respective connecting rod 56 is hinged for coupling the two handle levers 6, 8 with the drive mechanism 54. The input element is operatively connected via an internal sliding coupling 52 to an output member which is longitudinally movable mounted and has a locking/coupling section for the staple feed device of the currently used staple magazine 4 at its end distal. The connecting rods 56 that couple the input element to the handle levers 6, 8 are oriented proximally, from the handle levers 6, 8, in such a way that when the two handle levers 6, 8 are pressed together in the scissor handle mode, the input element and thus through the sliding coupling 52 the output element in direction moves proximally in the housing 2a.

It should be noted that the entire drive unit 54 is spring-loaded to the housing as described above, so that it moves elastically from the proximal position (compressed handle lever according to Figure 2) towards the distal position ( handle lever extended according to figure 1). It should also be noted that the construction of the drive unit 54 can also be designed differently, as long as a drive force is applied to the handle levers 6, 8 through an adaptation device (overload protection 50) corresponding to example input-output coupling unit to interrupt the flow of force when a predetermined actuation force is exceeded and thus allow the handle levers 6, 8 to idle (without force).

Both handle levers 6, 8 are each coupled via a further connecting rod 58 with the locking device 12 in the form of the handle shaft 10 mounted on the U-shaped slider. These two additional connecting rods 58 are oriented opposite to each other. the aforementioned connecting rods 56, so that when the two handle levers 6, 8 are pressed together in the manner of a scissor handle, the U-shaped slider 12 moves in the distal direction. Staple Loader Construction

Each staple magazine 4 according to figures 1 and 4 has a shaft section which, in terms of its dimensions, can be inserted into the U-shaped shaft 10 of the handle 2 and which also forms the staple receiving section (magazine). of staples) from the magazine 4 at the same time. For releasable fixing/locking on the handle 2, the essentially shaft-shaped staple magazine 4 has a mounting device 16 at the proximal end of the handle section, which works together with the bolt (clamping device) 18 of the handle. handle 2 to (partially) insert into shaft 10 of handle 2 to releasably lock staple magazine 4 inserted into handle 2.

According to Figs. 3 and 4, in the cutaway of the distal end of the staple magazine shaft section 4, a crimping tool 22 with a protruding crimping head (jaw portion) 20 is arranged. The crimping head 20 (hereinafter also referred to as the jaw part) is configured to interact with the closure device 12 of the handle 2, which is designed as a U-shaped slider, to form the crimping tool/crimping mechanism. 22 of the staple applier 1 together at the distal end of the staple applier 1.

For interaction with the closing device 12 configured as a U-shaped slider, the jaw part 20 (seen in its longitudinal direction) has a connecting (control) link 24 and 26 on the outside left and right. The links 24, 26 and the closing device 12 are each configured to jointly define an opening and closing movement of the jaw part 20. The position and geometric shape of the links 24, 26 of the jaw part 20 for the different staple magazines of the large number of staple magazines can be fixed/fixed individually, in particular depending on the selected staple magazine and/or the type of staple to be applied, since depending on the staple magazine and/or the type of staples, a larger/smaller jaw opening is required on the crimp head 20.

The opening and closing movement of the crimping head/jaw part 20 occurs when the locking device 12, which is designed as a U-shaped slider, at least partially encompasses the links 24, 26 of the jaw part 20 on the outside during its longitudinal movement in the axis of the handle 10, so that two internal surfaces (in Figure 2 not shown) of the U-shaped closure device 12 come into contact with the sliders 24, 26 and, therefore, Therefore, they also determine or control the opening and closing movement of the jaw part 20. To do this, the jaw part 20 and the locking device 12 are shaped or configured in such a way that the locking device 12, which is configured as a U-shaped slider, it at least partially surrounds the jaw part 20, which is fixed in the longitudinal direction of the axis 10 by means of the clamping part (screw) 14, when the two handle levers 6 and 8 I know manually operated (pressed together). This means that, when the handle levers 6, 8 are actuated by the rods 56, 58 of the handle 2 indicated above, the locking device 12 moves or pushes longitudinally in the distal direction of the staple applier 1 in the distal direction. until the locking device 12 engages around the hinges 24, 26 of the jaw part 20 and thus forces the jaw part 20 into a closing movement. This movement of the locking device 12, which is defined or controlled by the position and/or the shape of the sliders 24, 26, closes the jaw part 20 and reopens it after actuating or releasing the handle levers 6, 8. The opening movement results from a backward movement (from a distal perspective) of the closure device 12, which is designed as a U-shaped slider.

Figure 3 shows a bottom perspective view of the staple magazine 4, which has been partially disassembled for illustrative purposes or with individual components removed for clearer description.

In Figure 3, it can be seen that the crimping tool 22 is essentially fork-shaped and has two branches 28 and 30 parallel to each other. At the free ends of the crimping tool 22 pointing in the distal direction, it has two jaw parts 32 and jaw 34 formed in one piece, on which the joints 24, 26 described above are arranged/designed. and that form the jaw part (crimping head) 20. It can also be seen that the crimping tool 22 has at its proximal end a recess 36 as a fastening opening for engaging with the retaining part (screw) 14 of the handle 2. In this exemplary embodiment, the recess 36 is designed as an elongated hole, into which the retaining part 14 of the handle 2 engages. the assembled state to securely fix the crimping tool 22 fitted to the shaft 10 so that it cannot move in the longitudinal direction of the staple magazine 4 or in the longitudinal direction of the shaft 10 of the handle portion 2. In other In other words, the longitudinal position of the crimping tool 22 and thus of the jaw part 20 is fixed by the interaction of the recess 36 with the clamping part 14, so that it cannot move relative to the axis 10 of the handle 2, nor in relation to other components of the staple magazine 4.

The staple magazine 4 shown in Fig. 3 also has a staple feed device 38 in the form of a staple feed bar for picking up and feeding, ie transporting individual staples. The staple feed device 38 is configured to interact with the jaw piece 20 and is mounted movably relative to it in the longitudinal direction of the staple magazine 4 or in the longitudinal direction of the axis 10 of the handle 2. This means that the feeding device 38 has the function of taking individual staples from the staple magazine 4 and transporting them in the distal longitudinal direction of the shaft 10. To this end, the staple feeding device 38 has a staple tongue 40 at its distal end, with which individual staples can be picked up and fed or transported.

In order to pick up the individual staples from the staple magazine 4, the staple feeder 38 must be moved backwards (from the distal perspective), since the individual staples (from the distal perspective) are positioned behind the jaw pieces 32, 34 of the jaw part for storage. For this reason, the staple feeder 38 has to be moved rearward so that it is positioned (from a distal perspective) exactly behind the staple that will next be picked up and fed or conveyed forward in the longitudinal direction of the axis 10. in the direction of the jaw piece 20. On the other hand, for the delivery or transport of the collected staple by means of the staple feeding device 38, a forward movement (from a proximal perspective) is necessary to displace the collected staple in direction to the jaw part 20, that is, along the branches 28, 30 of the crimping tool 22 between the jaw parts 32, 34 to move it.

In order to easily limit these two longitudinal movements of the staple feeder 38, namely (from the proximal perspective) forward toward the jaw portion 20 and (from the proximal perspective) backward toward the staple receiving section (stock magazine). staples), the staple feeder device 38 has two stops 42 and 44 spaced longitudinally thereon. The limit stops 42, 44 are shaped and dimensioned in such a way that each of them can come into contact with the crimping tool 22, the longitudinal position of which is fixed with respect to the staple feed device 38 by means of the locking piece. latch 14 engaging in the recess 36. This means that the limit stops 42, 44 striking the crimping tool 22 limit the longitudinal movement of the staple feed device 38 in both longitudinal directions depending on the situation.

In this exemplary embodiment, the limit stops 42, 44 are formed in one piece with the staple feed device 38 as a stamped/bent piece. The distance in the longitudinal direction between the two stops 42, 44 is dimensioned or selected and fixed in such a way that the staple tongue 40 moves backwards (from the proximal point of view) of the staple feed device 38, i.e. , with a staple picking movement of the staple feeding device 38, exactly one staple is picked from the staple magazine 4, as will be explained in more detail below. In Figure 3, the staple feed device 38 is shown in a location/position where the proximal limit stop 44, that is, the rear limit stop in the staple feed direction, is in contact with the feed tool. crimp 22. According to Fig. 3, the staple feeder 38 is thus shown in a position where a single staple 46 was conveyed by means of the staple tongue 40 of the staple feeder. 38 towards the distal end of the jaw part 20, ie it was transported to or placed on the crimping tool 22.

It is clear that the position of the staple feeder 38 shown in Figure 3 is not (yet) a position in which the jaw pieces 32, 34 of the jaw portion 20 can be closed to crimp the inserted staple. For the closing of the jaw parts 32, 34, a backward movement of the staple feed device 38 is required beforehand, so that it is not completely disposed between the jaw parts 32, 34 in the position shown.

In Figure 4, showing a bottom perspective view of a partial section of the staple magazine 4 in a partially disassembled state, the staple feed device 38 is shown in a different location/position, in which it can accommodate the staple individual 46 of a staple storage section 48 of the staple magazine 4 for further delivery or transport to the jaw portion 20 (crimping tool 22). It can be seen that the staple storage section 48 (viewed from the distal end) is disposed behind the jaw pieces 32, 34 of the jaw portion, so that a single staple 46 (viewed from the distal end) has to be advanced or carried forward in order to be inserted between the jaw pieces 32, 34.

It can also be seen in Figure 4 that the staple feeder 38 in the illustrated staple receiving position rests against the crimping tool 22 with the distal limit stop 42, i.e., with the front limit stop in the opposite direction. staple feed direction, which limits the staple receiving movement in this direction of movement. The positioning of the end stop 42, which is correspondingly measured and set as a function of the staple magazine 4, ensures that only a single staple 46 is taken from the staple magazine 48 of the staple magazine 4 at a time and is moved accordingly. staple position in a subsequent staple forward movement in the forward direction toward the distal end of the crimping tool 22, which is carried between the jaw parts 32, 34 of the jaw portion or inside the portion gag 20.

In Figure 5, showing a perspective side view of the staple applicator 1 in a partially disassembled state, it can be seen that the handle 2 of the staple applicator 1 has an integrated overload protection 50 with a sliding coupling 52. The protection Overload guard 50 with slip clutch 52 prevents the handle mechanics 2 and/or the staple magazine mechanics or receiving parts 4, or also the stop 42 itself or the jaw part 20, from being damaged by forces of excessive user actuation when the forward stop 42 stops on the crimping tool 22. Since the distances between the stops 42, 44 of the staple magazine 4 are positioned or defined differently for the different staple magazines of the plurality of staple magazines, overload protection 50 can also ensure that a universal handle 2 can interact with several of the plurality of staple magazines without damaging the mechanics or the components of the respective handle 2 and/or

of the respective staple magazine 4 due to excessive manual actuation forces.

The operation or practical use of the staple applicator 1 can take place as described below.

Figure 2 shows a perspective side view of the staple applicator 1 in the assembled state, i.e. in the operative state, in which the staple magazine 4 is joined together by the interaction of the mounting device 16 and the clamping device. 18.

After mounting the staple applicator 1 by attaching the staple magazine 4 selected as required to the universal handle 2, the staple applicator 1 is in a functional state. In other words, in this state, the staple magazine 4 is inserted into the shaft of the handle 10 and is locked in place by the bolt 18.

By manually actuating the two handle levers 6 and 8 of the handle 2, the internal drive mechanism 54 of the handle 2 is activated in such a way that the closing device 12, which is designed as a U-shaped slider, moves longitudinally in the distal direction. Due to this longitudinal displacement of the closing device 12, it is pushed on the sliders 24, 26 of the jaw part 20, as a result of which the jaw parts 32, 34 are pressed towards each other, i.e. inwards. , and the crimping tool 22 is thus closed.

On the other hand (at the same time), the internal drive mechanism 54 of the handle 2 is also driven in such a way that the staple feed device 38 moves in a longitudinal movement against the closure device 12 (in the proximal direction). ) until the front stop 42 hits the stationary crimping tool 22 and, if necessary, the sliding coupling 52 of the overload protection 50 is activated. The internal drive mechanism 54 of the handle 2 then holds the staple feed device 38 in this position until the jaw parts 32, 34 are separated again by moving the closing device 12 back and the crimping tool 22 is opened again. In this way, a clearance is again created between the jaw parts 32, 34 of the jaw part, the staple feed device 38 being released (automatically) by means of the internal drive mechanism 54 and the next staple being fed. it can be transported through the staple tongue 40 between the jaw parts 32, 34 by a spring-loaded supported forward movement.

Briefly, a surgical staple applier with a universal handle and individual staple magazine with an integrated crimping head/crimping tool releasably attachable to the universal handle is disclosed. The universal handle and the individual staple magazine attached to it work together to form an input path that is either defined for actuation or individually available for staple transport of individual staples from a staple receiving section of the staple magazine to the crimp head. According to the invention, the individual staple magazine can be selected according to the needs of a large number of staple magazines for different types of staples, the staple magazine having an integrated coding mechanism that is designed depending on the type of staple to be to be applied and which, in cooperation with the universal handle, determines at least the feeding route adapted to the type of staple.

Claims (12)

1. A universal handle of a surgical staple applicator (1) on which can be mounted or attached an individual staple magazine (4) that can be selected from a number of different staple magazines and having a crimping head/tool (20, 22) so that the universal handle (2) and individual staple magazine (4) attached to it for crimping individual staples (46) into the crimping head/crimping tool (20, 22) and for transporting individual staples from a staple receiving section (48) interact mechanically through a single input path to the crimping head/crimping tool (20, 22), for which the universal handle (2) has a gear of integrated power transmission (54) with at least one manually grippable handle (6, 8) as drive input part and with a coupling as drive output part to the individual staple magazine (4), characterized by an adaptive device (50, 52) with overload protection (50) which is disposed between the drive input part and the drive output part to interrupt the transmission of force in the force transmission gear (54 ) when the transport of individual staples from the staple magazine (4) is limited by at least one stop (42, 44), for compensation/accommodation of staple-related differences between the individual input path of the individual staple magazine (4) currently connected and a maximum drive path of the drive input part on the universal handle (2). Universal handle according to claim 1, characterized in that the adaptation device (50, 52) is designed in such a way that the input route adapted to the respective staple type is determined or is determined by a coding mechanism (20 , 24, 26, 38, 42, 44) integrated into the individual staple magazine (4) currently assembled and designed according to the type of staple to be applied. Universal handle according to claim 1 or 2, characterized in that the overload protection (50) has a sliding coupling (52) or a release mechanism. Universal handle according to claim 3, characterized in that the slip coupling (52) is set to a slip value above the force required to transport individual staples from the staple magazine (48) through the single entry path to the crimping head/crimping tool (20, 22) and below a predetermined drive force that overloads the power transmission gear (54). 5. Surgical staple applicator (1), characterized by a universal handle (2) according to one of claims 1 to 4 and a single staple magazine (4) that is designed separately and to mount on the universal handle (2), which features a crimp head/crimp tool (20, 22), a staple receiving section (48) and a staple feeder (38) for transporting individual staples from the staple receiving section (48) through a single input path to the crimping head/crimping tool (20, 22) depending on manual actuation of the universal handle (2), wherein the staple feed device (38) is adapted to cooperate with a hooking/engaging portion at the distal end of the drive output portion/output element on the adapter ( 52) of the universal handle, and where the individual staple magazine (4), which can be selected as needed from a large number of staple magazines for different types of staples, has a staple type coding mechanism (20 , 24, 26, 38, 42, 44) integrated and depending on the type of staple to be applied with two delimiting stops (42, 44) to at least partially define the individual entry route adapted to the type of staple r specific to limit the movement of the staple feeding device (38) inside it in its two longitudinal directions. Surgical staple applicator (1) according to claim 5, characterized in that the coding mechanism has two delimiting stops (42, 44) which are spaced apart from one another in the longitudinal/movement direction of the staple feed device and whose positions are adapted depending on the type of staple to be applied in such a way that exactly one staple can be transported from the staple magazine (4) to the crimping head/crimping tool (20, 22) by a backward movement and/or forward of the feed device (38). 7. Surgical staple applicator (1) according to claim 5 or 6, characterized in that the staple feeding device (38) is a longitudinally movable rod, preferably in the form of a plate, where in addition, preferably , the at least one stop (42, 44) is integrated as a cutting and/or bending part in the rod. 8. Surgical staple applier (1) according to claim 5 or 6, characterized in that the crimping head/crimping tool (20, 22) is adapted to contact at least one stop (42, 44) of the clamping device. staple feed device (38) to limit a backward and/or forward movement of the staple feed device (38). Surgical clip applier (1) according to one of claims 5 to 8, characterized in that the universal handle (2) is designed as a reusable part. Surgical clip applier (1) according to one of claims 5 to 9, characterized in that the individual clip magazine (4) is designed as a disposable part. Surgical staple applier (1) according to one of the preceding claims 5 to 10, characterized in that the universal handle (2) and the individual staple magazine (4) have a color and/or symbol coding (5a, 5b) adapted to the type of staple to be applied to display the individual staple magazine (4) currently in use with the universal handle (2). 12. Surgical staple applier (1) according to one of the preceding claims 5 to 11, characterized in that the crimping head/crimping tool (20, 22) has a connecting rod that controls closing and opening, whose position and /or geometry depends on the type of staple to be applied and/or is adapted to the length of the staple magazine shaft (4).